Pharmacy Female Facial Hair Assessment

1IMPORTANT!

2Your Condition & Your Health

We will now ask you some questions to assess your suitability for a prescription

Just before you start, it is important that you read this:

Welcome to our online clinic. This assessment forms the basis of today's consultation. We need you to be honest with your answers so we can prescribe medication safely and give you the right advice. If you forget to tell us something or give inaccurate information, this may result in a drug being prescribed that harms rather than helps you. It's important that you tell us about any medication you are already taking when we ask for this.

Facial Hair can sometimes be as a result of acne, irregular periods or scalp hair loss. These can be indicative of an underlying condition, and so you should speak to your GP rather than continue. If your facial hair growth has been sudden, you should also stop, and speak to your GP.*

I don't have any of the above problems, and wish to proceed.

Name*

FirstLast

Which part(s) of your body are affected by excess hair growth?*

Face

Neck

Back

Chest

Other

Vaniqua will not help with groith of hair on your back

Vaniqua will not help with groith of hair on your Chest

Which other areas are affected by excess hair growth?*

Has there been an unusual and sudden growth of hair in the last few weeks/months?*

What does the excess facial hair look like?*

Vaniqua will not help with groith of thin, fine hair. It is only useful where hair is thick and coarse

Rosemount pharmacy began trading in the UK in 2010 and has progressed to partner with Simple Online Pharmacy to provide Online Pharmacy and Doctor services across the UK. Services are not intended as a replacement between you and your doctor, rather they are designed to support, and make more accessible certain services, should they be required. You should always read all product packaging and labels before use. If you have, or suspect you may have, a health problem you should consult your GP. Please also consult your GP or pharmacist before taking any new product, particularly if you are already under medical care.